February 22, 2002

by Michele Keller, Web Editor

Federal health officials released guidelines yesterday strongly urging women to get regular mammograms starting at age 40. According to a committee of researchers who contributed to the report, the benefits of mammograms are clear: Women screened for breast cancer routinely are less likely to die from the disease than women who are not screened.

Far too many women, however, lack the health insurance to pay for breast cancer screening.

Insurance policies that include mammograms often don't cover the full cost of care. For example, the recommended Medicare reimbursement rate for mammograms falls short. Routine screening mammograms usually cost between $75 and $150, while the Congress-recommended reimbursement rate under Medicare is only $67. The cost of a diagnostic mammogram (when a problem is suspected) may be more than $200, yet the reimbursement rate for that procedure is a woeful $81.

These low reimbursement rates have led to a scaling-back in the mammography services many clinics provide. With access shrinking, many women report that they face serious delays in obtaining a mammogram, even when suspicious lumps are detected. New York University Medical Center shut one of its two mammography services in 1999, as have several other clinics throughout the country. Hospitals may also reduce access to mammography services if reimbursement rates are not increased.